A1 Refereed original research article in a scientific journal
Lifestyle factors as predictors of nonadherence to statin therapy among patients with and without cardiovascular comorbidities.
Authors: Heli Halava, Maarit Jaana Korhonen, Risto Huupponen, Soko Setoguchi, Jaana Pentti, Mika Kivimäki, Jussi Vahtera
Publication year: 2014
Journal: Canadian Medical Association Journal
Journal name in source: CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
Journal acronym: CMAJ
Volume: 186
Issue: 12
First page : E449
Last page: E456
Number of pages: 8
ISSN: 1488-2329
DOI: https://doi.org/10.1503/cmaj.131807
Abstract
BACKGROUND\nEasily detectable predictors of nonadherence to long-term drug treatment are lacking. We investigated the association between lifestyle factors and nonadherence to statin therapy among patients with and without cardiovascular comorbidities.\nMETHODS\nWe included 9285 participants from the Finnish Public Sector Study who began statin therapy after completing the survey. We linked their survey data with data in national health registers. We used prescription dispensing data to determine participants' nonadherence to statin therapy during the first year of treatment (defined as < 80% of days covered by filled prescriptions). We used logistic regression to estimate the association of several lifestyle factors with nonadherence, after adjusting for sex, age and year of statin initiation.\nRESULTS\nOf the participants without cardiovascular comorbidities (n = 6458), 3171 (49.1%) were nonadherent with their statin therapy. Obesity (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.74-0.99), overweight (OR 0.88, 95% CI 0.79-0.98) and former smoking (OR 0.82, 95% CI 0.74-0.92) predicted a reduced risk of nonadherence in this group after ad justment for sex, age and year of statin initiation. Of the participants with cardiovascular comorbidities (n = 2827), 1155 (40.9%) were nonadherent. In this group, high alcohol consumption (OR 1.55, 95% CI 1.12-2.15), ex treme drinking occasions (OR 1.48, 95% CI 1.11-1.97) and a cluster of 3-4 lifestyle risks (OR 1.61, 95% CI 1.15-2.27) predicted increased odds of nonadherence after adjustment for sex, age and year of statin initiation.\nINTERPRETATION\nPeople with cardiovascular comorbidities who had risky drinking behaviours or a cluster of lifestyle risks were at increased risk of nonadherence. Among individuals without cardiovascular comorbidities, information on lifestyle factors was unhelpful in identifying those at increased risk of nonadherence; that overweight, obesity and former smoking were predictors of better adherence in this group provides insight into mechanisms of adherence to preventive medication that deserve further study.
BACKGROUND\nEasily detectable predictors of nonadherence to long-term drug treatment are lacking. We investigated the association between lifestyle factors and nonadherence to statin therapy among patients with and without cardiovascular comorbidities.\nMETHODS\nWe included 9285 participants from the Finnish Public Sector Study who began statin therapy after completing the survey. We linked their survey data with data in national health registers. We used prescription dispensing data to determine participants' nonadherence to statin therapy during the first year of treatment (defined as < 80% of days covered by filled prescriptions). We used logistic regression to estimate the association of several lifestyle factors with nonadherence, after adjusting for sex, age and year of statin initiation.\nRESULTS\nOf the participants without cardiovascular comorbidities (n = 6458), 3171 (49.1%) were nonadherent with their statin therapy. Obesity (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.74-0.99), overweight (OR 0.88, 95% CI 0.79-0.98) and former smoking (OR 0.82, 95% CI 0.74-0.92) predicted a reduced risk of nonadherence in this group after ad justment for sex, age and year of statin initiation. Of the participants with cardiovascular comorbidities (n = 2827), 1155 (40.9%) were nonadherent. In this group, high alcohol consumption (OR 1.55, 95% CI 1.12-2.15), ex treme drinking occasions (OR 1.48, 95% CI 1.11-1.97) and a cluster of 3-4 lifestyle risks (OR 1.61, 95% CI 1.15-2.27) predicted increased odds of nonadherence after adjustment for sex, age and year of statin initiation.\nINTERPRETATION\nPeople with cardiovascular comorbidities who had risky drinking behaviours or a cluster of lifestyle risks were at increased risk of nonadherence. Among individuals without cardiovascular comorbidities, information on lifestyle factors was unhelpful in identifying those at increased risk of nonadherence; that overweight, obesity and former smoking were predictors of better adherence in this group provides insight into mechanisms of adherence to preventive medication that deserve further study.
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